Join the hoppa club!

Registering to use the hoppa service is quick, easy and free. You can either complete the form on this page or call us on 01428 681701 and ask us to post you a registration form. Alternatively you can download our hoppa folder and registration form here.

Required information from applicants
All information will be treated confidentially and in accordance with the Data Protection Act 2018.

    Section A - Contact Information

    Name

    Address

    Postcode

    Date of Birth (dd/mm/yyyy)

    Telephone Number

    Mobile Number

    Email

    Who should be contacted in an emergency?

    (Please enter their name, telephone number and relationship to you.

    1. Name Tel No Relationship

    2. Name Tel No Relationship

    Section B - Please tell us why you would like to join the hoppa Club. Choose one or more from the following selection.

    Section C - Mobility Information

    Do you use a wheelchair?

    Manual or Electric?

    If you are a wheelchair user, can you transfer to a vehicle seat?

    Will a carer escort you?

    Do you use a walking stick?

    Do you use a walking frame?

    Do you have an illness, disability or difficulty that you wish to disclose so that we can better assist you and cater for your needs?

    Section D - Privacy and Security

    From time to time we would like to send you information about changes to our services and other general news and events concerning hoppa. Due to changes in Data Protection Legislation, we are now obliged to seek your permission to contact you, in order for us to do this please opt in by ticking one or more of the contact methods below*

    *You can unsubscribe or opt out at any time by contacting us by phone, email, post or text.

    In order to provide a professional and effective service we need to keep a record of personal information and we may need to be in contact to check the membership details. This is information, such as your name and contact details, the person to contact in case of an emergency and details of any special mobility requirements. All personal information is treated as private and confidential by all staff. It is recorded on a database digitally and or on paper. You have the right to see any information that we hold about you, and to have your details removed. We may compile statistical information for monitoring purposes but this will never include references to a particular individual. We will never share your data with any other organisations or individuals, and are committed to keeping your data safe and secure. We want you to know exactly how our services work and why we need your registration details; our Data Protection Policy can be viewed on our website at www.hoppa.org.uk or you can request a copy by calling 01428 681701

    For more information or to speak to a member of the team to discuss your membership or application please phone the enquiries line on 01428 681701.